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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1053705426 |
| LBN Legal business name | CENTERFORBRAIN |
| Authorized official | CAROLYN COHEN - (OFFICE ADMINISTRATOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/24/2015 |
| Last updated | 07/03/2019 - About 7 years ago |
| Identifiers | n/a |
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CENTERFORBRAIN
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CENTERFORBRAIN